Potomac Valley Swimming

ENTRY COVER SHEET

CLUB		CLUB CODE
CLUB FACILITY		COACH
CLUB/FACILITY OFFICIALS CONTACT		PHONE
MEET	SITE	DATE

	GIRLS				BOYS
	10 & U	11-12	13-14	15 & O	10-& U	11-12	13-14	15 & O	TOTALS
# SWIMMERS
# INDIVIDUAL EVENTS
# RELAY EVENTS

TOTAL INDIVIDUAL EVENTS	____________	X	__________	=	$ _____________
TOTAL RELAY EVENTS	____________	X	_ __________	=	$ _____________
TOTAL ENTRY FEE DUE				=	$ _____________

I ATTEST THAT THE ATHLETES ENTERED IN THIS MEET ARE PROPERLY REGISTERED WITH UNITED STATES SWIMMING, AND THAT THEY HAVE ACHIEVED THE SEED TIMES RECORDED.

TEAM REPRESENTATIVE'S NAME (PLEASE PRINT)
TEAM REPRESENTATIVE'S SIGNATURE
PHONE NUMBER

SEND MEET RESULTS DISK TO: ( CLUBS ENTERING ON DISK MAY HAVE RESULTS RETURNED BY MAIL IF A STAMPED, ADDRESSED DISK MAILER IS PROVIDED.)	NAME
	ADDRESS
	CITY
	STATE and ZIP

Have you included your entry fee check? YES / NO
Have you included pink/blue entry cards (if required)? YES / NO
Have you included one report by event and one report by name (disk entry only)? YES / NO

INCLUDE THIS ENTRY COVER SHEET WITH ALL ENTRIES.

Potomac Valley Swimming

ENTRY COVER SHEET

Have you included your entry fee check? YES / NO Have you included pink/blue entry cards (if required)? YES / NO Have you included one report by event and one report by name (disk entry only)? YES / NO

Issued 09/96

Have you included your entry fee check? YES / NO
Have you included pink/blue entry cards (if required)? YES / NO
Have you included one report by event and one report by name (disk entry only)? YES / NO